Drug information of Pantoprazole


Pantoprazole


Pantoprazole is a proton pump inhibitor that decreases the amount of acid produced in the stomach. Pantoprazole is used to treat erosive esophagitis (damage to the esophagus from stomach acid), and other conditions involving excess stomach acid such as Zollinger-Ellison syndrome. Pantoprazole is not for immediate relief of heartburn symptoms.

Mechanism of effect

Pantoprazole is a proton pump inhibitor (PPI) that suppresses the final step in gastric acid production by forming a covalent bond to two sites of the (H+,K+ )- ATPase enzyme system at the secretory surface of the gastric parietal cell

Pharmacodynamic

Pantoprazole is a substituted benzimidazole indicated for the short-term treatment . Pantoprazole is a proton pump inhibitor (PPI) that suppresses the final step in gastric acid production.

Pharmacokinetics

Pantoprazole is well absorbed. It undergoes little first-pass metabolism resulting in an absolute bioavailability of approximately 77%.Protein binding: 98%.Pantoprazole is extensively metabolized in the liver through the cytochrome P450 (CYP) system. After administration of a single intravenous dose of 14C-labeled pantoprazole to healthy, normal metabolizer subjects, approximately 71% of the dose was excreted in the urine with 18% excreted in the feces through biliary excretion. Half life: 1 hour.

Dosage

Usual Adult Dose for Erosive Esophagitis
Treatment of Erosive Esophagitis:
40 mg orally once a day for up to 8 weeks; however an additional 8 weeks may be considered for patients who have not healed after the initial treatment. Safety and efficacy beyond 16 weeks of therapy have not been established.
Maintenance of Healing of Erosive Esophagitis:
40 mg orally once a day. Controlled studies have been limited to 12 months of pantoprazole therapy.
Usual Adult Dose for Gastroesophageal Reflux Disease
Parenteral: 40 mg once a day for 7 to 10 days, administered via intravenous infusion over a period of 15 minutes. Intravenous therapy should be discontinued as soon as the patient is able to resume oral therapy.
Oral: 40 mg orally once a day, for short-term administration (up to 8 weeks); however an additional 8 weeks may be considered for patients who have not healed after the initial treatment. Safety and efficacy beyond 16 weeks of therapy have not been established.
Usual Adult Dose for Gastric Ulcer
40 mg orally once a day. Data have revealed that monotherapy with daily doses of 40 mg have been associated with complete gastric ulcer healing in up to 87% and 97% of patients after 4 weeks and 8 weeks respectively.
Usual Adult Dose for Zollinger-Ellison Syndrome
Parenteral: 80 mg every 12 hours, administered by 15-minute infusion. Daily doses higher than 240 mg administered in equally divided doses by 15-minute infusion, or administered for more than 6 days have not been studied.
Oral: 40 mg twice daily, to a maximum of 240 mg per day. Some patients have received treatment with pantoprazole for more than 2 years.

Alerts

1-Symptomatic response to therapy with Pantoprazole does not preclude the presence of gastric malignancy.
2-Atrophic gastritis has been noted occasionally in gastric corpus biopsies from patients treated long-term with Pantoprazole.
3-Acute interstitial nephritis has been observed in patients taking PPIs including Pantoprazole.
4-Daily treatment with any acid-suppressing medications over a long period of time (e.g., longer than 3 years) may lead to malabsorption of cyanocobalamin (vitamin B-12) caused by hypo-or achlorhydria

Points of recommendation

• Take without regard to meals.

Pregnancy level

B


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